Organization
RIVERSIDE HEALTH SOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER W AUSTIN JR. (SR VICE PRESIDENT/CFO)
(757) 875-7545
Entity
Organization
Contact information
Practice address
659 HOSPITAL RD STE 103A, TAPPAHANNOCK, VA 22560-7000
(804) 443-6276
Mailing address
608 DENBIGH BLVD STE 800, NEWPORT NEWS, VA 23608-4487
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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